 This paper examines the challenges faced when partnering between university-based researchers and health system leaders. It highlights the need for more research into how best to support evidence-informed decision-making and health systems. The authors argue that the current language used to describe partnerships between researchers and health system leaders does not accurately reflect the reality of the situation. They also suggest that health systems are still struggling to embrace evidence-informed decision-making, despite the fact that many health system leaders recognize its importance. Finally, they propose that complexity is easier to discuss than it is to act upon, and that there is a need for more action to be taken to ensure that evidence-informed decision-making becomes embedded in health systems. This article was authored by Bev J. Holmes.